Bronchoscopic treatment of a bronchopleural fistula after pneumonectomy

Menezes, Vanessa; Söder, Stephan; Kadadah, Sulaiman; Masson, Jean‐Bernard; Lafontaine, Edwin; Liberman, Moïshe

doi:10.1016/j.xjtc.2020.08.016

Cited by 5 publications

(5 citation statements)

References 5 publications

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“… 1 , 4 - 6 Surgical and bronchoscopic interventions such as pneumonectomy and lobectomy carry a high risk of BPF, which can be acute or subacute. 4 , 7 - 9 Nonsurgical causes of include infections, neoplastic lesions, trauma, and chemoradiation. 10 - 15 Complications from BPF include contamination of the pleural space, causing inflammation and empyema.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous Bronchopleural Fistula: A Rare and Life-Threatening Disease

Bathobakae,

Shahid,

Wilkinson

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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Tuberculous bronchopleural fistula (BPF) is a rare and potentially life-threatening complication of pulmonary tuberculosis, in which abnormal connections form between the bronchial tree and the pleural space. These abnormal connections allow air and secretions to pass from the lungs into the pleural space, causing a range of symptoms from benign cough to acute tension pneumothorax. The management of tuberculous BPF requires an individualized approach based on the patient’s condition and response to treatment. Anti-tuberculosis therapy is essential for controlling the active tuberculosis infections. Intercostal drainage and suction are also commonly used to drain air and fluid from the pleural space, providing relief from the symptoms. For some patients, more invasive surgeries, such as decortication, thoracoplasty or pleuropneumonectomy are required to definitively close the fistula when medical management alone is insufficient. Herein, we describe a rare case of tuberculous BPF in a young adult female, who was treated with anti-tuberculosis medications and open thoracotomy.

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Section: Discussionmentioning

confidence: 99%

Tuberculous Bronchopleural Fistula: A Rare and Life-Threatening Disease

Bathobakae,

Shahid,

Wilkinson

et al. 2023

Journal of Investigative Medicine High Impact Case Reports

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“…Similar to modified endobronchial stents, Amplatzer devices (Fig. 2), first developed for the closure of congenital atrial septal defects or patent foramen ovale, have also been utilized for BPF closure [47][48][49][50]. These devices have a central waist connecting two self-expandable disks of nitinol mesh.…”

Section: Interventions For Bronchopleural Fistulae Managementnonsurgicalmentioning

confidence: 99%

An update on bronchopleural fistulae following cancer-related surgery

Bashour

Ost

2023

Current Opinion in Pulmonary Medicine

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Purpose of ReviewBronchopleural fistulae (BPF) are rare complications in cancer-related surgery but impart significant morbidity and mortality. BPF may be difficult to identify, with a broad differential diagnosis at presentation, so it is critical to be aware of newer diagnostic and therapeutic approaches for this disease entity.Recent FindingsMultiple novel diagnostic and therapeutic interventions are featured in this review. Reports of newer bronchoscopic techniques to localize BPF, as well as approaches for bronchoscopic management, like stent deployment, endobronchial valve placement, or alternative interventions when indicated are discussed, paying particular attention to factors that influence procedure selection.SummaryManagement of BPF remains highly variable, but several novel approaches have shown improved identification and outcomes. Although a multidisciplinary approach is imperative, an understanding of these newer techniques is important to provide optimal care for patients.

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“…Menzes and colleagues 3 present a case report of a small left PP- BPF that was successfully closed with an Amplatzer Vascular Plug II (St. Jude Medical, St. Paul, Minn) deployed across the BPF. Eight weeks previously, the 64-year-old female patient had undergone left intrapericardial pneumonectomy with intercostal muscle flap bronchial coverage for non–small cell lung cancer after induction immunotherapy.…”

mentioning

confidence: 99%

“…This patient's only symptom was cough and bronchoscopy showed a 2-mm BPF in a viable left mainstem bronchial stump. 3 …”

mentioning

confidence: 99%